David Gratzer

Physician and author

Dr. David Gratzer is a physician and author. His articles have appeared in a number of publications, including The Wall Street Journal, The Weekly Standard, Los Angeles Times, The Globe and Mail, and Maclean’s. He blogs at FrumForum.com and wrote Code Blue: Reviving Canada’s Health Care System, a national bestseller.

If Canada has a weight issue (and increasing amount of studies say that it definitely does), should our physicians be doing more? The answer seems to be <em>yes</em>, but the problem is that docs aren't doing much in terms of preventative care for their patients.

Government program spending is still growing from sea to sea. Virtually every government in Canada is spending more in current dollars from one year to the next. Many are spending more in inflation-adjusted dollars, too. If they aren't, they're generally coming pretty close.

Many countries offer sophisticated medical care and universal coverage and yet have very different health-care models. And, more importantly, several of these countries achieve better health outcomes. To be fair, international health care rankings never offer a consensus on which country truly has "the best" system. But there is one area where these rankings are consistent: they usually place Canada and the U.S. mid to low pack. I believe both countries can do so much better.

The biggest target of obesity in North America? Soda. Many experts now claim that soda is the new tobacco -- indeed, Google those terms and you get more than 7 million hits. For them, Coke is the new Camel. Let me take a step back and note the basic problem in fighting obesity like we fought tobacco.

On Friday, Mark Carney told us that advocates of the so-called Dutch Disease theory have it wrong. A bit of data is a good thing in a heated debate. Consider Statistics Canada latest (seasonally adjusted) monthly manufacturing sales numbers covering June 2012 sales. And when you do, ask yourself a simple question: does the data support Dutch Disease -- or are we seeing a case of a Central Canadian Cold?

Only a few years ago, if you'd attacked a politician for his weight, or complained about where she ate her dinner, it would be seen as poor form. Reporters could write about a politician's views on taxes and trade, but the burgers and buns on his dinner plate were off limits. How times have changed.The fight against obesity has mobilized a growing number of public health zealots, who've taken a punitive, selective and judgmental approach to anti-obesity policy.

The student protests shut down Quebec higher education, gained international attention and shook that province's politics. By all accounts, the democratic protests were highly successful at gaining attention.There's only one catch: the protests were anything but democratic.
Indeed, it would have been illegal for any labour union in the country to conduct itself the way the student union leadership did. The next Quebec government needs to democratize the student associations. If they want the right to strike like regular labour unions, shouldn't they be held to the same basic democratic standards?

This week, novelist and columnist Steve Marche draws lessons from Canada's success for Bloomberg.com, in a cleverly titled piece, "Hardheaded Socialism Makes Canada Richer Than the U.S." Times are good today, but they may not be so good in a few years.

In mid-June, the federal government committed every Canadian man, woman and child to pay $15.79 to create jobs and build infrastructure in Michigan whose per capita income is nearly the same as Canada's. Weeks later, nobody here seems to have noticed. The foreign aid will cover that state's costs for a multi-billion dollar bridge project linking Michigan and Ontario. But this deal is a little too sweet for Michigan...

The implementation of Obamacare seems anything but straight forward. Costs have soared despite the fact that most reforms don't kick in until 2014; several states have effectively rebelled; one basic reform (the long-term care insurance) was already scrapped. The debate over American health care seems no closer to resolution.

When Premier Dalton McGuinty went looking for advice, he hired Don Drummond. What he got was an economist who told him to charge more for parking and amalgamate public health boards. What he needed more was an economist to explain how to get Ontario working again.

Canadians often grumble about their politicians. We are quick to blame Ottawa, and sometimes rightly so. But in the commitment of people like Sheila Copps, we should also remember that we are also very lucky. Political life is hard; the dedication of people like Copps is important.

Today, the premiers are meeting in Victoria. Top of the agenda: health care. It's a meeting that will be long on rhetoric but short on purpose. Historically, such meetings allow premiers to bemoan the lack of stable, long-term funding from Ottawa.

Stephen Harper suggested in 1997 that a non-Liberal party couldn't win the country and argued that the rules of the game needed to change. Lucky for him that he's better at campaigning than political prognosticating.

Here's the paradox in modern health care: medicine has never been better, but we seem to be getting collectively less healthy. Obesity rates continue to rise dramatically: One in four Canadians are overweight and among the heaviest of the Western world.

There is no single reform that is going to make medicare work better. But there is a general approach that would be useful. And that alternative approach recognizes the limitations of centralized planning and the need to allow more private money and leadership into the system.

There are more people in the world, yet we are collectively more free and prosperous. Global cooling and the viral Armageddon never happened. Communism ended, liberating Eastern Europe, all without a shot fired. Even the average IQ is -- amazingly -- trending up. The data is good. Really good.

Parliament has grown dysfunctional, with too little transparency. But while reform is desirable, the result may not be. Consider the "new" process for approving Supreme Court of Canada nominees. The only feisty moments occurred when an NDP MP challenged Moldaver over his inability to speak French.

Federal politicians promise more funding for the Canadian health-care system. But there's limited evidence that the sort of massive infusions of cash seen in recent years are making a material difference -- except that providers make better coin.